The biology of lung cancer

Lung cancer remains the major cancer killer worldwide. Although advances have been achieved in the past 20 years in understanding the important clinical and prognostic factors for both small cell lung cancer and non-small cell lung cancer, with few exceptions no significant advances have been made in therapeutic results. For patients who have small cell lung cancer, the hope for prolonged survival relates to the sensitivity of the tumor to chemotherapy, with or without radiation therapy. For patients who have non-small cell lung cancer, the only hope for survival is whether the tumor can be surgically excised. Despite only modest advances and responses to systemic treatment for lung cancer, there have been major advances in our understanding of the biologic properties of lung cancer throughout the past decade and a half. The development of numerous cell lines of both major cell subtypes of lung cancer has allowed an in-depth study of its biologic and molecular properties. This paper reviews recent developments in the biology of lung cancer and how these advances may impact on the treatment of patients who have this disease.